Skip to main content Accessibility help

Anxiety among informal hospice caregivers: An exploratory study

  • Karla T. Washington (a1), George Demiris (a2), Kenneth C. Pike (a3), Robin L. Kruse (a1) and Debra Parker Oliver (a1)...



This study examined the prevalence of clinically significant anxiety among informal hospice caregivers and identified the characteristics of caregivers who experienced anxiety of this severity.


An exploratory secondary data analysis pooled from three separate studies of informal hospice caregivers (N = 433) was conducted. Researchers employed descriptive statistics to calculate anxiety prevalence and utilized logistic regression to model the associations between the covariates (i.e., caregiver characteristics) and anxiety.


Overall, 31% of informal hospice caregivers reported moderate or higher levels of anxiety. Caregivers associated with the research site in the Northwest were less likely to be anxious than those in the Southeast [χ2(3, N = 433) = 7.07, p = 0.029], and employed caregivers were less likely to be anxious than unemployed caregivers (OR = 0.56, 95% CI = 0.33, 0.96). The likelihood of being anxious decreased with increasing physical quality of life (OR = 0.77, 95% CI = 0.69, 0.85), and younger female caregivers were more likely to be anxious than male caregivers and older females (OR = 0.95, CI = 0.91, 0.99).

Significance of Results:

A noteworthy number of informal hospice caregivers experience clinically significant levels of anxiety. Increased efforts to screen and address anxiety in this population are recommended.


Corresponding author

Address correspondence and reprint requests to: Karla T. Washington, Department of Family & Community Medicine, University of Missouri, MA306 Medical Sciences Building, DC032.00, Columbia, Missouri 65212. E-mail:


Hide All
Bryant, C., Jackson, H. & Ames, D. (2008). The prevalence of anxiety in older adults: Methodological issues and a review of the literature. Journal of Affective Disorders, 109(3), 233250.
Chentsova-Dutton, Y., Shucter, S., Hutchin, S., et al. (2000). The psychological and physical health of hospice caregivers. Annals of Clinical Psychiatry, 12(1), 1927.
Cooper, C., Katona, C., Orrell, M., et al. (2008). Coping strategies, anxiety and depression in caregivers of people with Alzheimer's disease. International Journal of Geriatric Psychiatry, 23(9), 929936.
Courtney, K., Demiris, G., Oliver, D.P., et al. (2005). Conversion of the Caregiver Quality of Life Index to an interview instrument. European Journal of Cancer Care (English Language Edition), 14(5), 463464.
Demiris, G., Oliver, D.P., Washington, K., et al. (2010). A problem-solving intervention for hospice caregivers: A pilot study. Journal of Palliative Medicine, 13(8), 10051011.
Demiris, G., Parker Oliver, D., Wittenberg-Lyles, E., et al. (2012). A non-inferiority trial of a problem-solving intervention for hospice caregivers: In person versus videophone. Journal of Palliative Medicine, 15(6), 653660.
Dumont, S., Turgeon, J., Allard, P., et al. (2006). Caring for a loved one with advanced cancer: Determinants of psychological distress in family caregivers. Journal of Palliative Medicine, 9(4), 912921.
Funk, L., Stajduhar, K., Toye, C., et al. (2010). Home-based family caregiving at the end of life, part 2: A comprehensive review of published qualitative research (1998–2008). Palliative Medicine, 24(6), 594607.
Given, B., Wyatt, G., Given, C., et al. (2004). Burden and depression among caregivers of patients with cancer at the end of life. Oncology Nursing Forum, 31(6), 11051117.
Grov, E.K., Dahl, A.A., Moum, T., et al. (2005). Anxiety, depression, and quality of life in caregivers of patients with cancer in late palliative phase. Annals of Oncology, 16(7), 11851191.
Grunfeld, E., Coyle, D., Whelan, T., et al. (2004). Family caregiver burden: Results of a longitudinal study of breast cancer patients and their principal caregivers. CMAJ: Canadian Medical Association Journal, 170(12), 17951801.
Haley, W.E., Allen, R.S., Reynolds, S.A., et al. (2002). Family issues in end-of-life decision making and end-of-life care. American Behavioral Scientist, 46(2), 284298.
Krasucki, C., Howard, R. & Mann, A. (1998). The relationship between anxiety disorders and age. International Journal of Geriatric Psychiatry, 13(2), 7999.
Lindstrom, K.B. & Mazurek Melnyk, B. (2013). Feasibility and preliminary effects of an intervention targeting schema development for caregivers of newly admitted hospice patients. Journal of Palliative Medicine, 16(6), 680685.
McMillan, S.C. (2005). Interventions to facilitate family caregiving at the end of life. Journal of Palliative Medicine, 8(Suppl. 1), S132S139.
National Hospice and Palliative Care Organization (2005). End-of-life caregiving. Available from
Pigott, T.A. (2003). Anxiety disorders in women. Psychiatric Clinics of North America, 26(3), 621672.
Sareen, J., Cox, B.J., Clara, I., et al. (2005). The relationship between anxiety disorders and physical disorders in the U.S. National Comorbidity Survey. Depression and Anxiety, 21(4), 193202.
Schulz, R., O'Brien, A., Czaja, S., et al. (2002). Dementia caregiver intervention research: In search of clinical significance. The Gerontologist, 42(5), 589602.
Spitzer, R.L., Kroenke, K., Williams, J.B., et al. (2006). A brief measure for assessing generalized anxiety disorder: The GAD-7. Archives of Internal Medicine, 166(10), 10921097.
Waldrop, D.P. & Meeker, M.A. (2012). Hospice decision making: Diagnosis makes a difference. The Gerontologist, 52(5), 686697.
Weisberg, R.B. (2009). Overview of Generalized Anxiety Disorder: Epidemiology, presentation, and course. Journal of Clinical Psychiatry, 70(Suppl. 2), 49.
Williams, A.L. & McCorkle, R. (2011). Cancer family caregivers during the palliative, hospice, and bereavement phases: A review of the descriptive psychosocial literature. Palliative & Supportive Care, 9(3), 315325.
Wittenberg-Lyles, E., Demiris, G., Parker Oliver, D., et al. (2012). Stress variances among informal hospice caregivers. Qualitative Health Research, 22(8), 11141125.
Yilmaz, A., Turan, E. & Gundogar, D. (2009). Predictors of burnout in the family caregivers of Alzheimer's disease: Evidence from Turkey. Australasian Journal on Ageing, 28(1), 1621.


Anxiety among informal hospice caregivers: An exploratory study

  • Karla T. Washington (a1), George Demiris (a2), Kenneth C. Pike (a3), Robin L. Kruse (a1) and Debra Parker Oliver (a1)...


Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed